Osteochondritis dissecans of the knee

Abstract

Osteochondritis dissecans (OCD) is a common cause of knee pain and dysfunction in both adult and skeletally immature patients. OCD is a focal lesion of subchondral bone and subsequently the overlying articular cartilage. Classically thought to be an acquired idiopathic lesion, OCD can lead to articular cartilage softening, swelling, delamination, partial detachment, and potentially complete osteochondral separation resulting in a loose body. The instability and cartilage damage that OCD lesions impart, as well as third body wear from resulting loose bodies, may contribute to premature osteoarthritis. When treating stable, juvenile OCD, the majority of patients can achieve a favorable outcome with conservative, non-operative management. Surgical intervention is dependent on lesion stability, physeal status, and clinical symptoms. Surgical intervention types can be separated into palliative, reparative, and restorative techniques. The overall goal for the treatment of OCD lesions is to relieve pain, reduce mechanical symptoms, and prevent development of secondary osteoarthritis.